Perform daily audits on client data for completeness and accuracy of coding using clinical knowledge.
Respond to provider appeals and meet client turnaround time and KPI goals.
Utilize coding validation training to become familiar with claims payment policies and regulations.
Cotiviti is a healthcare analytics company that uses data-driven solutions to improve payment accuracy and quality in healthcare. The company offers a competitive benefits package and fosters a collaborative, fast-paced work environment.
Validate accuracy of CPT, HCPCS, revenue codes, and billed line-item charges on outpatient and inpatient facility claims.
Apply CMS guidance, coding guidelines, and industry standards during claim review, including hospital bill audits and itemized bill reviews.
Prepare appeal responses using applicable coding guidance and maintain required certifications and continuing education.
Trend Health Partners is a tech-enabled payment integrity company that facilitates collaboration between payers and providers to reduce waste and improve access to healthcare. They are a dynamic growing organization promoting a collaborative and innovative work environment.
Perform medical claims audit reviews with a focus on the Home Health sector, applying medical review guidelines and documenting findings.
Collaborate with the audit team to identify vulnerabilities, generate audit letters, and support findings during appeals.
Maintain knowledge of coding systems (ICD-10, CPT-4, HCPCS) and regulatory changes to ensure high-quality, deadline-driven work.
Machinify is a leading healthcare intelligence company that delivers value, transparency, and efficiency to health plan clients using an AI-powered platform. Deployed by over 85 health plans, including many of the top 20, and representing more than 270 million lives, the company fosters a collaborative, fast-paced remote culture.
Conducts baseline, routine, and focused audits comparing medical record documentation to reported CPT/HCPCS and ICD-10-CM codes.
Researches, interprets, and communicates federal and state laws and guidelines pertaining to CMS and Medicare.
Acts as an internal expert on coding issues to ensure compliance with state and federal regulations.
Privia Health is a technology-driven national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and focuses on scalable operations and cloud-based technology to reduce healthcare costs.
Perform detailed medical record reviews to validate DRG assignments and ensure billing accuracy.
Conduct clinical and coding audits to identify discrepancies and support cost containment.
Collaborate with quality teams and medical professionals to ensure compliance with payer regulations.
The company partners with healthcare organizations to ensure accuracy in medical coding and reimbursement. They offer a fully remote, supportive environment with comprehensive benefits and professional growth opportunities.
Provide medical coding, system configuration, and administrative support for medical policy functions.
Perform coding analyses and utilization reporting to recommend updates to medical policies and system configuration.
Participate in cross-functional meetings to align with enterprise strategic priorities and support team operations.
Wellmark is a mutual insurance company owned by policy holders across Iowa and South Dakota, built on over 80 years of trust. We prioritize member well-being over profits, with a focus on sustainability and innovation.
Responsible for coding procedures and entering charges to comply with federal/state regulations and internal policies.
Coordinate with Practice Coordinator and Revenue Integrity to ensure all necessary documentation is present to support selected procedure codes.
Participate in audits to evaluate coding accuracy and develop methodologies to improve coding issues identified.
Northside Hospital is an award-winning, state-of-the-art healthcare system. It is continuously growing and offers opportunities for healthcare professionals.
Serve as an expert in coding guidelines and perform audits to ensure compliance.
Develop and deliver role-specific training and educational materials for coding staff.
Analyze billing/coding behavior and recommend improvements.
UW Medicine is Washington’s only health system with a top-rated medical school and an internationally recognized research center. Nearly 29,000 healthcare professionals, researchers, and educators work within its family of organizations.
Lead analysis and delivery of coding, billing, and policy solutions from requirements to implementation.
Translate complex medical coding concepts into clear documentation and actionable deliverables.
Act as a key liaison between operations, technical teams, and client stakeholders to ensure alignment.
Partner company focused on healthcare operations, medical coding, and policy. They offer a fully remote environment with comprehensive benefits and professional development opportunities.
Review and abstract professional medical records to ensure accurate code assignment.
Assign ICD-10-CM, CPT, HCPCS, and applicable modifiers following national and payer-specific guidelines.
Maintain coding quality metrics and participate in coding audits.
We reimagine how people access care by bringing it directly into their homes. We have supported over 2 million patients across 22 states, completed over 130,000 in-home visits, and raised over $125M from top investors.
Responsible for coding procedures and entering charges to comply with federal/state regulations.
Coordinate with Practice Coordinator and Revenue Integrity to ensure documentation supports procedure codes.
Participate in audits to evaluate code accuracy and develop methodologies to improve coding issues.
Northside Hospital is an award-winning, state-of-the-art healthcare provider in Atlanta, Georgia. It is continually growing, offering opportunities for healthcare professionals in a supportive environment.
Conduct coder QA, provide educational feedback, and develop performance improvement plans.
Prepare and present coding curricula and regulatory updates to coders and providers.
Utilize revenue cycle knowledge to analyze coding data, support audits, and maintain shared resources.
US Anesthesia Partners is a leading provider of anesthesia services and revenue cycle management. The company operates across the US and emphasizes a collaborative culture focused on compliance and quality.
Support quality assurance and audit planning for the WTC Health Program
Analyze claims data to identify trends and recommend improvements
Maintain health plan codebook and ensure accurate medical coding standards
Advanced Technologies & Laboratories International, Inc. (ATL) provides expertise in quality assurance, claims processing, medical coding, and audit activities for the WTC Health Program. The company offers a competitive total compensation package and invests in professional growth through tuition reimbursement and certification programs.
Manage and resolve claims rejections and denials, escalating trends as identified.
Verify patient eligibility and benefits, and coordinate with insurance payers.
Maintain compliance with HIPAA regulations and meet productivity standards.
Workit Health is an industry-leading provider of on-demand, evidence-based telemedicine care for addiction. They are a growing company with a dedicated team passionate about making judgment-free care accessible.
Manages a remote team of behavioral health coding auditors, ensuring audit quality and team performance.
Serves as subject matter expert in behavioral health CPT coding, DSM-5 diagnostic coding, and payer requirements.
Drives operational strategy including capacity planning, staffing, and quality standards for behavioral health audit operations.
Machinify is a leading healthcare intelligence company delivering value and efficiency to health plan clients. Deployed by over 85 health plans, including many of the top 20, and representing over 270 million lives, they offer a flexible and trusting remote work environment.
Perform retrospective and concurrent Quality Assurance audits of inpatient encounters for accuracy and compliance.
Identify areas of educational opportunities and provide feedback to Coding Leadership.
Audit scope includes both government and commercial payors including RAC and ACHA.
Baptist Health is a faith-based, not-for-profit health system providing preventive and specialty care in Northeast Florida through over 200 locations and six hospitals. Recognized as a top workplace and most preferred provider for more than 25 years, it was recently named a top employer for diversity by Forbes.
Review and validate medical codes for accuracy and compliance with ICD-10, CPT, HCPCS, and other coding systems.
Provide expert coding guidance and support to clinicians and departments, serving as a resource for complex coding questions.
Conduct coding audits, generate productivity reports, and collaborate with IT and billing teams to resolve system issues.
Mission Healthcare is a home health and hospice company serving seven states, the largest of its kind in the western United States. They emphasize a culture of compassion, accountability, respect, excellence, and service (CARES) and are committed to diversity and inclusion.
Perform precise coding of telemedicine visits using CPT, ICD-10-CM, and HCPCS Level II codes in compliance with US healthcare standards.
Manage insurance claims processing, including submission, tracking, and resolution of denials or rejections.
Maintain accurate patient billing records and verify insurance eligibility and benefits.
Dr House is a trusted leader in telemedicine, providing high-quality virtual healthcare services across the United States. The company is a dynamic and fast-growing telemedicine firm that seeks to make healthcare more accessible and convenient for patients nationwide.
Conduct training and education on risk adjustment documentation and coding guidelines for providers.
Perform comprehensive medical record chart audits to validate ICD-10-CM coding and HCC assignments.
Analyze claims data and audit error rates to identify trends and recapture opportunities for chronic conditions.
Privia Health is a technology-driven, national physician enablement company that collaborates with medical groups, health plans, and health systems to optimize physician practices and improve patient experiences. The company is led by top industry talent and exceptional physician leadership, with scalable operations and cloud-based technology.
Reconcile daily payment batches in Candid against bank deposits and resolve unapplied items.
Audit claim and payment data for accuracy, proper denial status, and correct payer assignment.
Validate reimbursement amounts against contracted fee schedules and expected payments.
Expressable is a virtual speech therapy practice on a mission to transform care delivery and expand access to high-quality services. Since 2019, we have served thousands of clients and are a fast-growing, fully remote team dedicated to parent-focused intervention and improving outcomes.